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QI have recurring heavy periods which distress and inconvenience me. What is wrong with me? A Don't worry, you're not alone, one in 20 women aged 30-49 consult their general practitioner each year with heavy periods, which is now called heavy menstrual bleeding.

If consulting your GP they will ask questions about the amount and duration of the bleeding and whether it is bleeding between the periods, or after sexual intercourse. The GP may perform a blood test to exclude anaemia.

An ultrasound scan may be performed to exclude uterine fibroids (benign growths in the womb) or to possibly diagnose polyps within the womb cavity.

Q What are the causes of my condition? A In 40-60% there is no identifiable cause, known as dysfunctional uterine bleeding. Heavier periods are more prevalent at the onset of periods and prior to the menopause. Causes could include fibroids and polyps and more rarely a bleeding condition that affects the way the blood clots.

Q What is the best course of treatment for me? A If there are no obvious problems identified by a blood test or ultrasound scan, drug treatments may be used.

Tranexamic acid is a tablet that helps the way the blood clots within the womb and reduces blood loss by up to 50%. Nonsteroidal anti-inflammatory medications such as mefenemic acid may also be used.

If contraception is required, a combined oral contraceptive pill can reduce heavy periods.

The mirena intrauterine system is a plastic device placed in the womb which releases the hormone progestogen. It is a contraceptive and can stop periods and may reduce bleeding by up to 90%.

For women over 45 or those women who do not respond to treatment it may be necessary to perform a biopsy of the lining of the womb. Some women who have completed their family may opt for an endometrial ablation; a procedure to destroy the lining of the womb.

* Consultant obstetrician and gynaecologist Jonathan Pembridge runs private gynaecology clinics from Vale Healthcare's hospital in Hensol, near Cardiff.
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Title Annotation:Features
Publication:Western Mail (Cardiff, Wales)
Date:Jul 23, 2012
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